Endovascular aortic repair – initial experience in the Serbian bi-centric study

Summary BACKGROUND: Introduction of novel procedures needs to be planned and modified according to the situation in the society. The first endovascular aortic repair (EVAR) in Serbia was performed in 2004, and this activity was routinely continued in 2007. Aim of the study is to present the problems encountered during the introduction and development of endovascular program in Serbia, and to report the early experience and mid-term results of the two main Serbian vascular centers. METHODS: From March 2007 to November 2010, 1650 patients were operated due to abdominal aortic aneurysm (AAA) in the two main vascular centers in the capital of Serbia. Out of them 87 (5.27%) were treated by EVAR and are included in this Serbian bi-centric study that analyze results as well as developing process. RESULTS: Early mortality rate was 2/87 (2.29%). In the early postoperative time and after mid-term follow-up of 17.9 months (range 2–40 months) there was no aneurysm-related death. All patients with unplanned iliac conduit procedure suffered postoperative complications and dyed. Primary technical success and assisted primary technical success were recorded in 81 (93.1%) and 86 (98.85%) patients, respectively. Initial, assisted initial, short term and mid-term clinical success were recorded in 83 (95%), 84 (96.55%), 84 (96.55%) and 81 (93.10%) patients, respectively. CONCLUSIONS: Steep learning curve is a consequence of measured and planned introduction of new procedure only in a high volume centers with previous significant experience in treatment of all vascular pathologies and complications.